Pathologic evaluation of prostatic carcinoma: critical information for the oncologist

During the last few years, pathologists have assumed several important roles in the assessment of adenocarcinomas of the prostate. The establishment of postoperative serum prostate-specific antigen (PSA) levels as a sensitive indicator of progression following radical prostatectomy has provided the impetus to correlate pathologic findings with progression following surgery. The advent of the thin needle biopsy gun and screening with serum PSA has dramatically increased the number of needle biopsies performed to rule out prostatic adenocarcinoma. With these very limited tissue samples, pathologists are challenged to make diagnoses, as well as to accurately grade and quantify the tumor. This article explores topical issues in the pathology of prostate adenocarcinoma, with particular emphasis on practical aspects of pathologic evaluation that oncologists need to know for patient management.